Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier 26 Low / Median / High Price $83.17 / $83.17 / $111.14	Facility	26	$83.17	$83.17	$111.14
Aetna Facility/Professional Professional Modifier Low / Median / High Price $326.94 / $475.00 / $999.00	Professional		$326.94	$475.00	$999.00
Aetna Facility/Professional Professional Modifier 26 Low / Median / High Price $83.17 / $129.63 / $382.62	Professional	26	$83.17	$129.63	$382.62
Aetna Facility/Professional Professional Modifier TC Low / Median / High Price $243.76 / $335.00 / $501.95	Professional	TC	$243.76	$335.00	$501.95
Ambetter Facility/Professional Professional Modifier 26 Low / Median / High Price $64.04 / $83.25 / $98.79	Professional	26	$64.04	$83.25	$98.79
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $380.35 / $567.19 / $834.37	Professional		$380.35	$567.19	$834.37
Anthem BCBS Facility/Professional Professional Modifier 26 Low / Median / High Price $83.34 / $98.05 / $154.53	Professional	26	$83.34	$98.05	$154.53
Anthem BCBS Facility/Professional Professional Modifier TC Low / Median / High Price $290.58 / $472.00 / $674.54	Professional	TC	$290.58	$472.00	$674.54
CareSource Facility/Professional Professional Modifier Low / Median / High Price $90.88 / $126.45 / $454.38	Professional		$90.88	$126.45	$454.38
Cigna Facility/Professional Facility Modifier 26 Low / Median / High Price $97.25 / $97.25 / $97.25	Facility	26	$97.25	$97.25	$97.25
Cigna Facility/Professional Professional Modifier Low / Median / High Price $412.44 / $934.63 / $1,656.68	Professional		$412.44	$934.63	$1,656.68
Cigna Facility/Professional Professional Modifier 26 Low / Median / High Price $78.55 / $127.75 / $203.37	Professional	26	$78.55	$127.75	$203.37
Cigna Facility/Professional Professional Modifier TC Low / Median / High Price $311.55 / $835.83 / $1,478.56	Professional	TC	$311.55	$835.83	$1,478.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.34 / $32.34 / $610.04	Professional		$32.34	$32.34	$610.04
United Facility/Professional Professional Modifier Low / Median / High Price $360.14 / $699.46 / $1,045.89	Professional		$360.14	$699.46	$1,045.89
United Facility/Professional Professional Modifier 26 Low / Median / High Price $79.89 / $93.69 / $133.16	Professional	26	$79.89	$93.69	$133.16
United Facility/Professional Professional Modifier TC Low / Median / High Price $289.08 / $681.30 / $882.19	Professional	TC	$289.08	$681.30	$882.19